TY - JOUR
T1 - Predictive Factors for Response and Survival in a Cohort of Oligometastatic Patients Treated With Stereotactic Body Radiation Therapy
AU - Franceschini, Davide
AU - De Rose, Fiorenza
AU - Franzese, Ciro
AU - Comito, Tiziana
AU - Di Brina, Lucia
AU - Radicioni, Gianluca
AU - Evangelista, Andrea
AU - D'Agostino, Giuseppe Roberto
AU - Navarria, Pierina
AU - Scorsetti, Marta
N1 - Copyright © 2019 Elsevier Inc. All rights reserved.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - PURPOSE: This study evaluated patients, treatment, or disease characteristics that could predict response to stereotactic body radiation therapy (SBRT) and survival in a database of patients with oligometastatic disease from different solid tumors.METHODS AND MATERIALS: Patients treated with SBRT for oligometastatic disease between 2014 and 2015 were included. Patients were defined as oligometastatic if they were affected by a maximum of 5 active lesions in 3 different sites. They had to be treated with SBRT with radical intent.RESULTS: The study included 358 patients. With a median follow-up of 31.83 months, local control at 6 and 24 months was 94.6% and 78.9%, respectively. Distant progression was recorded in 279 patients (77.9%). Progression-free survival at 6 and 24 months was 66.1% and 18.4%, respectively. At last follow-up, 195 patients (54.5%) were still alive in 59 cases with no evidence of disease. The median overall survival (OS) was 34.7 months (95% confidence interval, 29.66-43.83). OS at 6 and 24 months was 96.07% and 63.57%, respectively. On multivariable analysis, the presence of lung metastases (hazard ratio [HR], 0.50 [0.33-0.75]; P = .001) and nodal metastases (HR, 0.44 [0.24-0.78]; P = .005) was related to longer OS. Primary lung cancer (HR, 1.89 [1.14-3.13]; P = .013), increasing age (HR, 1.02 [1.01-1.04]; P = .002), and the presence of metastatic sites other than the irradiated ones (HR, 2.19 [1.39-3.43]; P = .001) were all independent predictors of shorter OS. Local response was associated with OS.CONCLUSIONS: SBRT for patients with oligometastatic disease is effective. Local response is strongly correlated with patients'' prognosis, also underlying its relevance in a metastatic setting.
AB - PURPOSE: This study evaluated patients, treatment, or disease characteristics that could predict response to stereotactic body radiation therapy (SBRT) and survival in a database of patients with oligometastatic disease from different solid tumors.METHODS AND MATERIALS: Patients treated with SBRT for oligometastatic disease between 2014 and 2015 were included. Patients were defined as oligometastatic if they were affected by a maximum of 5 active lesions in 3 different sites. They had to be treated with SBRT with radical intent.RESULTS: The study included 358 patients. With a median follow-up of 31.83 months, local control at 6 and 24 months was 94.6% and 78.9%, respectively. Distant progression was recorded in 279 patients (77.9%). Progression-free survival at 6 and 24 months was 66.1% and 18.4%, respectively. At last follow-up, 195 patients (54.5%) were still alive in 59 cases with no evidence of disease. The median overall survival (OS) was 34.7 months (95% confidence interval, 29.66-43.83). OS at 6 and 24 months was 96.07% and 63.57%, respectively. On multivariable analysis, the presence of lung metastases (hazard ratio [HR], 0.50 [0.33-0.75]; P = .001) and nodal metastases (HR, 0.44 [0.24-0.78]; P = .005) was related to longer OS. Primary lung cancer (HR, 1.89 [1.14-3.13]; P = .013), increasing age (HR, 1.02 [1.01-1.04]; P = .002), and the presence of metastatic sites other than the irradiated ones (HR, 2.19 [1.39-3.43]; P = .001) were all independent predictors of shorter OS. Local response was associated with OS.CONCLUSIONS: SBRT for patients with oligometastatic disease is effective. Local response is strongly correlated with patients'' prognosis, also underlying its relevance in a metastatic setting.
KW - Adenocarcinoma/mortality
KW - Aged
KW - Confidence Intervals
KW - Female
KW - Humans
KW - Lung Neoplasms
KW - Lymphatic Metastasis
KW - Male
KW - Middle Aged
KW - Neoplasm Metastasis/pathology
KW - Prognosis
KW - Progression-Free Survival
KW - Radiosurgery/methods
KW - Retrospective Studies
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1016/j.ijrobp.2018.12.049
DO - 10.1016/j.ijrobp.2018.12.049
M3 - Article
C2 - 30630030
VL - 104
SP - 111
EP - 121
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
SN - 0360-3016
IS - 1
ER -